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Home My WebLink AboutPermit Electrical 2006-1-24 (2) , \ CITY OF SPRIN~,_.iELD, OREGON .' ZON 0! /' INITIALS I tl DATE "l,:,~^ SOURCE~ \ - 2.4:-0.6 " 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(54I)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number COM ?..OO~- ~ ~ d.- Date 1. "LOCA110N OF INSTALLATION 3. :COMPLe'TE-FEE sCHEDiiiE-BElmv- l_____.~.____ ~__..____.,-.;.,..~ ---~ ...- - -'._- '319)1 ~I'.fl&..&vl ~/.tI / LEGAL DESCRIPTION ,/ ~ ,/ /70~;</<.fd:l.o~l-/.oo- JOB DESCRIPTION A. ' New Residential- Single or Multi-Family per dwelling unit. L _, .._., __._~__ _ ..~- .-.-.- - -.--,. -- - ...- - -- - Service Included N\ l-\ f F_e.:l:> E. t<- 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Mauufact'd Homc or Modular Dwclling Service or Feeder $106.00 $ 19.00 Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. r- - .-- - -. - ----. .----. -- --: 2. ~ COl!!~CT()R.JNS!ALLATlON ONLY I Electrical Contractor 4 .J. ~ ~ " C 50-1 5 \ - $50.00 SO.IX' B.! Servi;"~ ~;Feede;s -=-In;t;;;i~;ion, Alle;~tions ;r Reloc~;ion; -- '~"---' - ------~- . -- - - ---_.._. . "'-.----- -. ! , ( ) ~ Signature of Supervising Electrician ")( f4/L ~vL Installation, Alteration or Relocation >>- 200 Amps or less e,c, ",0 ..::,011-'" ,\~ $ 50.00 .,~ ." \0 201 Amps to~OO A!l)ps C;~\"'\ $ 69.00 401 Amps"tb'600~mps-c'o'" \-' $100.00 r.: '.:(\..... "J ('). J " r$'l\' .\~ \.~e ~ ~,'~ ",'j\" .~,e~~9~Js~~~Qog.~01~ sco "B" a_bove. cP)'liJ.lranch"Clr~U1t~,'O. \., ,.' .<~~~:~e,":~w"it<'f~~:'O~~~~::si~~-;e;;~~e~~-' - ---- --' ~' ~' ,,- '\.- ,'()" "\,, " ' . . ')~o ~o OriitCircuit , \. , ". . $ 43.00 , 00\" 50 iE~ch""A'ddit;6nal Circuit or with E-\-t ~ O'i" 'S~ice 'O~le'eder Permit $ 3.00 OwnersNamG.e.",_~"~u....E.-Y ,... t:>EA\11b$~9'~~~1.0"""'~ _._______ .-----. . Addrcss ':> '('ct'C) c:-~ ~'1<-L.l K ~,-0 t>. E:,t,J\iiscelia~eous (Service/feeder not included) -Each Installation, \" --"- - -- -- ---_._-_.._-~ Phonc l '2..-(o-~:z.. 7C:::. Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 Limited EnergylResidcntial $ 25:00 Limited Energy/Commcrcial $ 45.00 200 Amps or less 20 I ~ps to 400 Amps l?", ,,'/1. \ .<u'40~ Ariijls to 600 Amps , \'i: \" \S \' ,/ ''Y>-~'i:.. ~*601~tpPS to 1000 Amps City J~ 1 p,) Phone kif'} - .'f~\9i,q.c.3'i:: ~\.Qv~r 1000 AmpslVolts . ~j\\"ft.~,<!:~J:rfj;~t~'$~~",~'V\J Reconnect Only ~ S 'Y'i:: 1Y'V ~ ,S r- -.- ----- -- - Supervisor License Number,\'-" J0~'r~~",co.\\)'V' C. Jell\P?rary S.e~vic~ o':..Fe~~__ ",'0 \ ~\.~v'V~' ~ b' /z q,~r\~ W . Constr. Contr. Number / (?d ") ') .t:. d"fl.\ ). C. $ 63.00 $ 75.00 $125.00. $163.00 $375.00 '$ 50.00 . ) Address Expiration Date Expiration Date t/Zq'J, 7 city:E 0 G. ~ IZ.- OVVNERINSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Inspection Request: 726-3769 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4'I_SUBTO~~?F~~~:_'~~=-~-=1 50.co 4-. CO 5.00 S~.ro 8% State Surcharge 10% Administrative Fee . Owners Signature: TOTAL Sharl:d Driv<<T:)IBuilding Forms/Electrical Pcnnit Application 1-06.doc f/ 5:9, 0 0 . . .1 CITY OF ~rK11'\juFIELD " Status Issued Building/Combination Permit PERMIT NO: COM2006-00094 ISSUED: 01124/2006 APPLIED: 01124/2006 EXPIRES: 07/24/2006 VALUE: $ 13,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 3998 FRANKLIN BLVD SPACE I Eugene' TYPE OF WORK: Manufactured Home In Park ASSESSOR'S PARCEL NO.: 1703344202400 TYPE OF USE: New Residential PROJECT DESCRIPTION: Placement permit. -" Owner: GREEN VALLEY ENDEAVORS LLC Address: 3998 FRANKLIN BLVD EUGENE OR 97403 Phone Number: 541-726-8236 . , ., . I CONTRA:CTOR INFORMATION I \y..'- S ~\J . Contractor Type Contractor .;o\\\\;. ~o.*\\ ;(\\\ License Electrical FATHER &<SON,SOF ORJ:GON INC 100726 ...~\.. ....\\.J;....~~\" ManufHome Inst n(...FAJID,!lR-,~';l!ON~,W'-UREGON INC 100726 ~(S\~'~'i:.\\~~S~ '0~~ {" ~~. I BUILDING INFORMATION' \'0'\ '0(J\\\ x.\J \;.\\\\:J' 00 ,O~ # of Units: ~'0\ 't..*\;.~rv ~ <( # of Stories: \\e'" ~ \i~' 0\'"'' Lot Size: . Primary OccupancY19jloup~o\:J \J Height of Structur~~o..~ \e0,o'" ",,<' ~ \)\)\ Sq Ft 1st Floor: Secondary Occupancyt.Gj..;up: Type ofHeat~\\'O-~ X-e 0 ",?}e C!J<:''/..: .'" \;Sq Ft 2nd Floor: . Primary Construction Type Water ryp.~? '0'\" e \J.e 0\>-<:0 ,,\-c ,v ",Sq Ft Basement: Secondary Construction Type: R~~~.~.TYp'!::~\,<,O<; 00r!;;' 0' ~ i\~""u.' \~q' Ft Garage/Carport # of Bedrooms: .Energy;Path:. .... 'S'\ (\,e" e,e ,,\..~""Sq Ft Other: 'X:'\".... . ~ r:.'V ~ 'V O'\" .~, . \0' ,.:\-<\ Sp'rinkJ!:.d.B,!!!di~g:,G :l.e.'\:.~a' '" Occupant Load: r ......~ ......(:\ 3'''\ ._\()' ,.,..\0 H~\ .,0. . Expiration Date 06/29/2007 06/29/2007 Phone 541-689-5090 541-689-5090 Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: ,..... ".~ .... I DEVEEOfMENTaNFORMATIOWI '. ",V' ....U. 'S'e . ,-,e ~ \''O~ \ 'O"Cf)'I,."o.DI '0\" \\'" , ve~_a~,.........st~,,.,(\\.1O # Street.Trees'Rqd: \,. Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: . I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: DownspoutslDrains: Notes: " . Paee I of3 'l . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax .. 541-726-3769 Inspection Line Description Tvpe of Construction Fee Description + 10% Administrative Fee + 10% Administrative Fee + 8% State Surcharge + 8% State Surcharge ManuC Home State Issuance Manufactured Home Conn - Plmb '. Manufactured Home Feeder , Manufactured Home Placement Total Amount Paid . . CITY OF ~rKli~uFIELD Building/Combination Permit PERMIT NO: COM2006-00094 ISSUED: 01124/2006 APPLIED: 01124/2006 EXPIRES: 07/24/2006 VALUE: $ 13,000.00 I Valuation Descrintion I $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project ~ FpPo.l:IilLI Amount Paid Date Paid Receipt Number 2200600000000000116 2200600000000000091 2200600000000000116 2200600000000000091 2200600000000000091 2200600000000000091 2200600000000000116 2200600000000000091 $5.00 $20.50 $4.00 $16.40 530.00 $45.00 $50.00 $160.00 1/24/06 1/24/06 1/24/06 1/24/06 1/24/06 1/24/06 1/24/06 1/24/06 $330.90 I Plan Reviews. I . To Request an inspection call the 24 hour recording at 726-3769. All inspection requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. ManufHome Set Up: When Installation of all piers or stands Is complete. Final Manuf Home Set Up: After all required Inspections are requested and approved and porches, skirting, decks, venting, street address numbers, trees, driveway, etc. have been Installed. ManufHome Plumbing: After home has been connected to water and sewer. MH Electric: When blocking, setup and plumbing Inspections have been approved and the home Is connected to the panel. q" Pal!e 2 of3 . . I ~I CITY OF SPRINGFIELD ,; Status Issued Building/Combination Permit PERMIT NO: COM2006-00094 ISSUED: 01/24/2006 APPLIED: 01/24/2006 EXPIRES: 07/24/2006 VALUE: $ 13,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all Information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the _ street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all times during construction. - :' ,2.1";Po J1-..~ /~2t..{.,Ob Owner or Contractors Signature Date o Pal!e30f3 . 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone c, Job/Journal Number COM2006-00094 COM2006-00094 COM2006-00094 Payments: Type of Payment Check I ;l , :, :\ 'i .. '\ , :, ;~ :.: I;'.., " 1/24/2006 RECEIPT #: Description Manufactured Home Feeder + 8% State Surcharge + 10% Administrative Fee Paid By H & H PRE-OWNED CLIENT TRUST ACCOUNT 6 2200600000000000116 Received By jmp Cbeck Number Batcb Number Page 1 of I Mity of Springfield Official Receipt Woevelopment Services Department Public Works Department Date: 01/24/2006 Item Total: Autborization Number 2603 2:35:5IPM Amount Due 50.00 4.00 5.00 $59.00 How Received In Person Amount Paid $59.00 Payment Total: $59.00